Reasons to be cheerful

Recovery is not only possible, it is common.

Eddie et al, 2020

If you are looking for reasons to be cheerful in these testing times, read on. I’ve been taking a look at a piece of research (1), about to be published, from the Recovery Research Institute in Massachusetts, which examined questionnaire responses from over 25,000 people who identified as having a past alcohol or drug problem which was now no longer problematic. The researchers say that while most alcohol and other drug disorders remit, little is known about the details of people’s achievements on the way. They wanted to shine a light on this. The findings are encouraging and cheered me up.

What’s the point?

The researchers were looking to quantify the achievements gained by people as recovery takes hold. Much addiction research measures the lowering or abolition of negatives (less drug use, less crime, less mental illness, fewer viral infections), but David Eddie and his colleagues had recovery in mind. They cite past research that shows people who overcome alcohol and other drug use disorders often go on to reach many of their goals, get on better with their families and become active again in society. Because of that they become happier, more confident and have improved psychological health.

Why bother?

So why do this research at all? Eddie and colleagues lay out that much of the existing research is on patients in addiction treatment programmes or in mutual aid groups. They wanted a much more representative sample including people who got better without formal treatment. They also wanted to look at the detail. How many saw achievements accruing? When did they occur? What factors were influencing the improvement? So they asked a lot of people a lot of questions to find out.

How did they do it?

The questions were across four themes:

1. Self improvement
2. Family engagement
3. Civic participation
4. Economic participation

More specifically, they asked questions around substance use; mental health diagnosis; treatment; mutual aid; psychological distress; self-esteem/happiness; quality of life; recovery capital and achievements. Achievements included things like volunteering, getting a new job or a promotion, helping others, getting into education, completing education, financially supporting one’s family or regaining child custody, voting, giving to charity, buying a home and/or a car etc.

What did they find?

More than 80% had attained at least one achievement on the researchers’ list and more than 60% had achieved two or more, with achievements growing the longer recovery continued. Black and Hispanic individuals did better than white individuals, possibly mediated by greater family engagement. Those in education seemed to gain more achievements overall compared to those not in education, suggesting education helps multiple trajectories.

Being in a 12-step mutual aid group was also associated with a greater number of achievements overall, driven by greater civic participation – probably related to the 12-step emphasis on helping others. Although the numbers were smaller for non-12-step mutual aid, there were grounds to be optimistic that this benefit may also be true of other mutual aid groups too.

The authors acknowledge that the methods used in the study had limitations and that ‘effect sizes were… generally fairly small’, but that given the complexity and multiple variable studied this was to be expected.

Push and Pull

They also point out that factors that move people towards recovery can be ‘push’ or ‘pull’. Push factors are things like hitting rock bottom or other negative consequences, but pull factors are the positives that come into lives (e.g. achievements) as recovery progresses and these seem to be important for the journey. Indeed, getting better from a substance problem ‘is far more than the removal of alcohol and drugs from an otherwise unchanged life’. It involves the gains, achievements and rewards that are at the heart of the process of recovery.

In my experience, when people report improvements as recovery takes hold, they don’t say ‘I’m grateful I have fewer drinking days’ or ‘So happy I reduced my blood borne virus risk’, they talk about hope, happiness, connection with others and feeling good about themselves again. These are the things that matter most.

Take home message

“Most recovering individuals accomplish several achievements associated with self-improvement, family engagement, and civic and economic participation. Further, these achievements are independently associated with measures of well-being including greater self-esteem, happiness, quality of life, and recovery capital.”

Now, isn’t that something to be cheerful about?

(1) Eddie, David & White, William & Vilsaint, Corrie & Bergman, Brandon & Kelly, John. (2020). Reasons to be cheerful: Personal, civic, and economic achievements after resolving an alcohol or drug problem in the United States population. Psychology of Addictive Behaviors. In press.

A copy of the paper can be requested via ResearchGate. Thanks to Davie Eddie and Bill White for correspondence on the research.